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A MODEL FOR DENTAL CARE IN A SCHOOL BASED PROGRAM

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A MODEL FOR DENTAL CARE IN A SCHOOL BASED PROGRAM CHEMAWA INDIAN HEALTH CENTER DENTAL PROGRAM Beth Finnson, RDH, MPH Oral Health in America A Report of the Surgeon ... – PowerPoint PPT presentation

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Title: A MODEL FOR DENTAL CARE IN A SCHOOL BASED PROGRAM


1
A MODEL FOR DENTAL CARE IN A SCHOOL BASED
PROGRAM
  • CHEMAWA INDIAN HEALTH CENTER
  • DENTAL PROGRAM
  • Beth Finnson, RDH, MPH

2
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3
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4
Oral Health in America
  • A Report of the Surgeon General
  • David Satcher, MD, 2003
  • Silent epidemic affecting
  • Poor children
  • Elderly
  • Racial and ethnic minority groups

5
World Health Organization
  • Dentaldisease is not eradicated,
  • but only controlled

6
Dental Caries
  • Chronic childhood disease
  • 51 million school hours lost yearly
  • 164 million work hours lost yearly
  • 16,000 school hours lost yearly in Oregon

7
Oral Health and General Health
  • Optimal oral health provides
  • Speaking
  • Smiling
  • Chewing
  • Tasting
  • Swallowing

8
Oral Health and Learning
  • Early tooth loss results in
  • Failure to thrive
  • Impaired speech development
  • Malocclusion
  • Reduced self esteem

9
Oral Health and Learning
  • Chronic Dental Pain causes
  • Anxiety
  • Fatigue
  • Irritability
  • Depression
  • Inability to concentrate
  • Poor nutrition

10
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11
OUR MISSION
  • To raise the physical, mental, social, and
    spiritual health of American Indians and Alaska
    Natives to the highest level.

12
OUR GOAL
  • To assure that comprehensive, culturally
    acceptable personal and public health services
    are available and accessible to American Indian
    and Alaska Native People.

13
OUR FOUNDATION
  • To uphold the Federal Governments obligation to
    promote health American Indian and Alaska Native
    people, communities, and cultures and to honor
    and protect the inherent sovereign rights of
    Tribes.

14
IHS/Tribal Healthcare Systems
  • 48 hospitals
  • 280 health centers
  • 147 health stations
  • 34 urban health projects
  • 9 residential treatment centers
  • 176 Alaska village clinics

15
Chemawa Indian Health Center
16
Indian Health Disparities
  • 55 AI/AN rely only on IHS healthcare
  • Reduced life expectancy
  • Higher infant mortality rate
  • Safe/adequate water supplies
  • Waste disposal facilities

17
Indian Population
  • 1997-1999 Current Population Survey
  • Larger families
  • Less health insurance
  • Lower household median income
  • Lower educational levels
  • Higher unemployment rates
  • Young population

18
Service Population Trends
  • 65 population increase (1990-2006)
  • Increase in life expectancy (64-73)
  • Federal recognition for more tribes
  • 56 urban
  • 44 reservation or rural areas
  • Inadequate IHS budget

19
Indian Health Service
  • Mobile Dental Van

20
Challenges in IHS Dental Programs
  • 2,800 patients per IHS dentist
  • 1,500 patients per U.S. dentist
  • 50 average IHS expenditure per patient
  • 300 average U.S. per patient
  • 25 dental access for Indian people

21
Oral Disease Trends
  • 76 pre-school children with caries
  • 68 adolescent children with caries
  • Increased access for sealants
  • 63 8 year-olds with at least 1 sealant

22
Chemawa Indian School
  • Forest Grove

23
Chemawa Indian School
  • Indian Boys

24
Chemawa Indian School
  • Salem, OR

25
Chemawa Indian School
  • Totem Pole

26
Chemawa Health Center
  • Comprehensive health care facility
  • Medical Pharmacy
  • Dental Public Health
  • Optometry Behavioral Health
  • Lab School Nursing
  • Radiology Podiatry Registration/Billing/C
    oding

27
Chemawas Model for A Dental SBHC Program
  • Collaboration
  • School staff
  • Health facility staff
  • Dental students
  • Dental hygiene students
  • Volunteers

28
Model for Dental SBHC
  • Screen process
  • Document, document, document
  • Prioritize
  • Preventive care
  • Clinical care
  • Specialty care
  • Evaluation

29
Documentation
  • Name Hygiene care
  • Chart Sealants
  • Home state Retention Rates
  • Screen date Extractions
  • Exam date Root canals
  • Number of caries PTC
  • Urgent needs Drop

30
Screen Results 2007-2008
  • 462 students, aged 14-19
  • 349 screened
  • 99 have had dental caries
  • 82 with untreated decay
  • 15 reported oral pain

31
Treatment Results 2007-2008
  • 51 complete exams
  • 9 extractions
  • 99 oral hygiene education cleaning
  • 85 received 498 dental sealants
  • 47 completed treatment

32
Screen Results 2008-2009
  • 387 students, aged 14-19
  • 387 screened
  • 97 have had dental caries
  • 73 with untreated decay (1395 carious teeth)
  • 14 reported oral pain

33
Receipt of Preventive Services by Low Income
Children
1996
2000
2010 Target 57
Note Data are for children under 19 years. Low
income is less than 200 of poverty level.
Preventive services include examinations,
cleaning, x-rays, fluoride treatments and sealant
applications. Source Medical Expenditure Panel
Survey, AHRQ.
Obj. 21-12
34
Dental Sealants 1988-94 and 1999-2000
1988-94
1988-94
1999-2000
1999-2000
Percent
2010 Targets
Total
Black
Mexican American
White
Total
Black
Mexican American
White
6-11 Years
12-18 Years
Note Targets are for children 8 years and 14
years. Black and white exclude persons of
Hispanic origin. Persons of Mexican-American
origin may be any race. Source National Health
and Nutrition Examination Survey, NCHS, CDC.
Obj. 21-8
35
Dental Sealants
36
Adolescents 12-18 Years Who Ever Had Caries in
Permanent Teeth, 1988-94 and 1999-2000
Percent
1999-2000
2010 Target
1988-94
Male
Female
Total
Black
Mexican American
White
Note Target is for adolescents 15 years old.
Black and white exclude persons of Hispanic
origin. Persons of Mexican-American origin may be
any race. Source National Health and Nutrition
Examination Survey, NCHS, CDC.
Obj. 21-1c
37
Oregon Smile Survey 2007
  • 3,865 1st,2nd 3rd graders
  • Oregon ranks 25/32 states
  • Disease disparities
  • Geographic
  • Poverty
  • Dental insurance
  • Race/ethnicity

38
Oregon Smile Survey 2007
  • 64 of children have had dental caries
  • 20 of children with rampant decay (7)
  • 35 of children with untreated decay
  • 25 with no dental insurance
  • 9 with no dental home
  • 20 need urgent care due to pain/infection
  • 43 with dental sealants

39
Oregon Smile Survey
  • Recommendations
  • Community water fluoridation
  • Early-childhood cavities prevention
  • School based fluoride supplement program
  • School based dental sealant programs

40
Resources
  • Oregon Dental Association
  • Oregon Dental Hygienists Association
  • Dental Foundation of Oregon
  • Tooth Taxi
  • Medical Teams International Mobile Dental Van
  • Boys and Girls Club

41
Resources
  • Oregon Smile Survey
  • Burden of Disease in Oregon
  • Oral Health Data Book
  • King Fluoride
  • Dental Sealants Protect Oregon Teeth
  • A Guide
  • http//www.oregon.gov/DHS/ph/oralhealth

42
Tooth Taxi
43
Questions ?
  • Beth Finnson, RDH, MPH
  • Chemawa Indian Health Center
  • 3750 Chemawa RD NE
  • Salem, OR 97305
  • 503-304-7631
  • beth.finnson_at_ihs.gov
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